Dermatophytosis is one of the major public health problems in tropical countries, especially the chronic recurrent type. Tinea imbricata (TI), a dermatophytosis caused by Trichophyton concentricum (TC), is endemic in several remote and isolated areas in Indonesia. This dermatophytosis is unique due to its predominant genetic predisposition, which leads to chronic recurrent conditions among the affected. Moreover, hot and humid climate, low socio-economic conditions, lack of hygiene, inadequate treatment due to difficult access to health care facilities, and persistent source of re-infections, are among other factors that maintain the chronic-recurrent state. Studies on TI in Indonesia have been done since the 1960s, encompassing the epidemiology, clinical features, and efficacy of antifungal treatment. Griseofulvin is still the mainstay treatment, but relapse rates are high. The latest effort in reducing relapse includes the training of healthcare providers and provision of fungal disinfectant for clothing and bedding to patients in West Papua in addition to standard treatment. Higher cure rate was achieved at the end of treatment and the four-month follow-up in comparison to previous studies. Parallel studies on the same patient populations showed that: 1. clothing and bedding were fomites and potential sources of re-infections; 2. sodium hypochlorite worked well as a fungal disinfectant, followed by anionic detergent and pine oil containing cleaner; 3. terbinafine was the most effective antifungal agent for TC in vitro, followed by griseofulvin; itraconazole, and fluconazole were less effective. In conclusion, to eradicate TI in endemic areas, appropriate and affordable antifungal treatment, concurrent with health education and efforts to identify and eradicate the source of re-infections are very important.
Climate ; Clothing ; Detergents ; Fluconazole ; Follow-Up Studies ; Fomites ; Genetic Predisposition to Disease ; Griseofulvin ; Health Education ; Health Personnel ; Health Services Accessibility ; Humans ; Hygiene ; Indonesia ; Itraconazole ; Naphthalenes ; Public Health ; Recurrence ; Sodium Hypochlorite ; Tinea ; Trichophyton

Trigonella foenum-graceum L. (fenugreek) is a phytoestrogen, a nonsteroidal organic chemical compound from plants which has similar mechanism of action to sex hormone estradiol-17β. This study aims to assess the effectivity of fenugreek seeds extract on collagen type I alpha 1 (COL1A1) and collagen type III alpha 1 (COL3A1) which are both decreased in aging skin and become worsen after menopause. This in vitro experimental study used old human dermal fibroblast from leftover tissue of blepharoplasty on a postmenopausal woman (old HDF). As a control of the fenugreek's ability to trigger collagen production, we used fibroblast from preputium (young HDF). Subsequent to fibroblast isolation and culture, toxicity test was conducted on both old and young HDF by measuring cell viability on fenugreek extract with the concentration of 5 mg/mL to 1.2 µg/mL which will be tested on both HDF to examine COL1A1 and COL3A1 using ELISA, compared to no treatment and 5 nM estradiol. Old HDF showed a 4 times slower proliferation compared to young HDF (p<0.05). Toxicity test revealed fenugreek concentration of 0.5 – 2 µg/mL was non-toxic to both old and young HDF. The most significant fenugreek concentration to increase COL1A1 and COL3A1 secretion was 2 µg/mL (p<0.05).
Aging ; Blepharoplasty ; Cell Survival ; Collagen Type I ; Collagen Type III ; Collagen ; Enzyme-Linked Immunosorbent Assay ; Estradiol ; Female ; Fibroblasts ; Humans ; In Vitro Techniques ; Menopause ; Phytoestrogens ; Skin ; Toxicity Tests ; Trigonella